NPIMap

Individual provider Active NPI

Blake Andrew Wynia, M.D.

  • Urology Physician
  • Greenville, SC
National Provider Identifier
1942591961
Registry record updated Feb 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
40721 Issued in SC
Practice address
48 Centennial Way
Greenville, SC 29605-4662
Phone
(864) 455-1600
Fax
(864) 522-8005
NPI assigned
Apr 25, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 40721 SC Primary

Addresses

Primary practice location

48 Centennial Way
Greenville, SC 29605-4662

Mailing address

300 E McBee Ave FL 4
Greenville, SC 29601-2842
Phone (864) 522-8603

Other practice location 1

15 Park Creek Dr
Greenville, SC 29605-4270
Phone (864) 797-7450

Other practice location 2

2 Medical Park Rd Ste 300
Columbia, SC 29203-6839
Phone (803) 434-4790

Other identifiers 1

IdentifierTypeStateIssuer
407214MedicaidSC

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address bwynia172979@direct.ghs.myhfn.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170912000149 SC Practitioner - Urology 2264725431 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
University of New Mexico School of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Prisma Health University Medical GroupGroup PAC ID 8325950983, 2,467 clinicians

Practice addresses (Care Compare)

15 Park Creek Dr
Greenville, SC 29605-4270
Phone (864) 797-7450

Hospital & facility affiliations

  • Prisma Health Greenville Memorial Hospital Hospital, Greenville, SC, CCN 420078
  • Prisma Health Greer Memorial Hospital Hospital, Spartanburg, SC, CCN 420033
  • Prisma Health Hillcrest Hospital Hospital, Simpsonville, SC, CCN 420037
  • Prisma Health Oconee Memorial Hospital Hospital, Seneca, SC, CCN 420009
  • Prisma Health Patewood Hospital Hospital, Greenville, SC, CCN 420102
  • Prisma Health North Greenville Ltach Long-term care hospital, Travelers Rest, SC, CCN 422008

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Prisma Health University Medical Group CurrentSince Aug 28, 2017 Accepting new patients
Prisma Health Medical Group-Midlands CurrentSince Feb 5, 2023 Accepting new patients
Prisma Health University Medical Group Current Accepting new patients
Prisma Health Medical Group-Midlands Urology CurrentSince Feb 5, 2023 Accepting new patients

Locations

2 Medical Park Rd
Ste 300
Columbia, SC 29203
Phone (803) 434-8800

2 Medical Park Rd
Ste 506
Columbia, SC 29203
Phone (803) 434-3930

210 Freeman Farm Rd
Duncan, SC 29334
Phone (864) 968-5123

15 Park Creek Dr
Greenville, SC 29605
Phone (864) 271-7761

1 Independence Pt
Ste 212
Greenville, SC 29615
Phone (864) 797-6306

1025 Verdae Blvd
#C
Greenville, SC 29607
Phone (864) 286-7550

48 Centennial Way
Greenville, SC 29605
Phone (864) 455-1600

2A Cleveland Ct
Greenville, SC 29607
Phone (864) 271-7761

300 E McBee Ave
Fl 4
Greenville, SC 29601
Phone (864) 522-8615

Interoperability endpoints

  • Direct secure messaging: bwynia172979@direct.ghs.myhfn.org

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 56

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 56

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1303689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675296000000",
    "number": "1942591961",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 E MCBEE AVE FL 4",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296012842",
            "telephone_number": "864-522-8603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "48 CENTENNIAL WAY",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296054662",
            "telephone_number": "864-455-1600",
            "fax_number": "864-522-8005"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15 Park Creek Dr",
            "address_purpose": "LOCATION",
            "city": "Greenville",
            "state": "SC",
            "postal_code": "296054270",
            "country_code": "US",
            "telephone_number": "864-797-7450",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2 Medical Park Rd Ste 300",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "SC",
            "postal_code": "292036839",
            "country_code": "US",
            "telephone_number": "803-434-4790",
            "fax_number": "803-434-4799",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WYNIA",
        "first_name": "BLAKE",
        "middle_name": "ANDREW",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-04-25",
        "last_updated": "2023-02-02",
        "certification_date": "2023-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "SC",
            "license": "40721",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "407214",
            "state": "SC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bwynia172979@direct.ghs.myhfn.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "bwynia172979@direct.ghs.myhfn.org",
            "address_1": "48 Centennial Way",
            "city": "Greenville",
            "state": "SC",
            "country_code": "US",
            "postal_code": "296054662",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

Verify at the official NPI Registry.